Government-run Healthcare Would Backfire, Making 'Public Option' the Only OneFormer DNC chair's government-run insurance program is sure to backfire. Just ask his wife the doctor By Phil Gingrey, M.D. Posted May 21, 2009

Former Democratic National Committee Chairman Howard Dean has recently inserted himself into the debate on health reform, creating a website and collecting signatures on a petition calling for a "public option" as part of any health reform bill. The action is unsurprising from an individual who previously called President Obama's healthcare reform plan "perfect" and stated that "it's ridiculous to say care would be inferior" in the government-run plan. But even as Governor Dean attempts to attract support for government-run healthcare, it's worth pointing out that the factsnot to mention his own personal experiencedon't mesh with his rhetoric.

As Vermont's governor, Dean aggressively pursued expansions of government-run health insuranceand bragged that doing so "was very cheap to do." Unfortunately for beneficiaries on state-run Medicaid and children's health insurance, that "cheap" coverage often came at a very steep price. Low reimbursement rates mean that few doctors actually participate in the government-run plan, so patients can't see their personal physicianand may not be able to see any physician when they need one.

In Vermont, one of those physicians whom Medicaid beneficiaries couldn't visit was Judith SteinbergHoward Dean's wife. In 1998, low reimbursement ratescoupled with the impact of additional regulations her husband signed into lawprompted Dr. Steinberg to end participation in the state's largest Medicaid-managed care program. As a result, the residents of Shelburne in Vermont's largest Medicaid plan lost access to the only primary care provider in town who would accept their insurance.

I don't fault Dr. Steinberg for her decisionit may well have been the only rational business decision for her to make. But for Governor Dean to claim that a government-run plan won't be "inferior" is to ignore his wife's experience, and that of the many beneficiaries who lost access to their physician due to Medicaid bureaucracy and poor coverage. My fear is that creating a government-run health insurance plan wouldn't guarantee quality care by physiciansin fact, it will not guarantee care at all.

The quality of care in a government-run health plan may seem irrelevant to those individuals who are happy with the coverage they currently haveafter all, President Obama promised during his campaign that, "If you like the plan you have, you can keep it." But most individuals don't really have their own health coveragethey get it from their employers. And if the coverage provided in the government-run plan is cheaper than what employers are paying now, logic suggests that employers will drop their current plans and place their workers in the government plan.

Estimates from independent actuaries at the Lewin Group suggest that well over half of all Americans currently with employer-sponsored health coveragenearly 120 million individualswould lose their current coverage due to the creation of a government-run health plan. And the change in coverage would not be a "choice"according to Lewin studies, employers would drop their plan options, dumping employees into the government-run health plan to save money.

So the end result of the "perfect" plan supported by Governor Dean would be most people losing the coverage they have, while ending up on a government-run plan that dominates the healthcare marketplace. Physicians would be forced to accept the government's low reimbursement ratesbut my experience, to say nothing of Dr. Steinberg's, strongly suggests that many will not. Some baby boomer doctors may view a move to government-run health insurance as a reason for them to take early retirement. Some physicians may refuse all insurance entirely, relying solely on a "cash-and-carry" approach to treating patients. Other physicians may be forced to lay off staff to compensate for a sharp drop-off in income. And other would-be physicians may decide not to practice at allforsaking medical school for other careers that could be more rewarding and less bureaucratic than government-dictated medicine.

Republicans believe that a government-run health plan that doesn't guarantee access to carelike the Medicaid program in Governor Dean's hometownisn't real coverage at all. That's why House Republicans have formed a working group, on which I sit, to develop solutions that will expand access to affordable, quality healthcare. Our working group's proposals will keep doctors and patients, not government bureaucrats, at the center of healthcare.

Governor Dean may claim that a government-run health plan would not provide "inferior" healthcare, but the citizens of his hometownand even his wifemay disagree. Republicans believe that Americans deserve better. And we look forward to working to achieve that aim.

In CA, Medi-Cal (CA Medicaid) reimbursement levels are about 20% on the dollar, compared to private payors and even the federal Medicare rates, which most providers complain are well below actual costs. As I recall, “regular” office visits were reimbursed at laughably low levels.

Many urban clinics and public hospitals get by, through heroic efforts, but they are stuggling and closing at alarming rates. Other private hospitals just shift costs on to private insurers or use elaborate billing schemes to recover their expenses.

Government run health care plans are the cause of this mess in the first place. They created the need to cost shift to those who either have great insurance plans, or can pay cash. Universal health care is a ruse. Snake oil salesman Obama tells you you will have health care...but alas no one to offer care is to be found. Hospitals will shutter their doors, doctors will retire and no one in their right mind will take on the educational costs of becoming a doctor. Patient - heal thyself!!! We will go back to the dark ages of polstices and old wives remedies. You better brush up on what your grandmother told you as there will be no cure for anything and no need for research hospitals.

5
posted on 06/10/2009 10:02:17 PM PDT
by Semperfiwife
(It is a tale, told by an idiot.....living in DC)

They claim that 50 million Americans don't have health care. If they really intend to give them full health care that means that the nurses and doctors that give care to 250 million Americans would then have to provide for all 300 million. But 0bummer is already running doctors and nurses out of the profession by mandating that they must provide abortions. Not to mention they will have to work for less money, as the article says, and where the government requires them to work.

Someone explain to me how fewer doctors and nurses, making less money will give more people better health care than most Americans get now?

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